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10070035 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10385 CALVERT DR CONTRACTOR:BESTBUILD PERMIT NO: 10070035 CONSTRUCTION INC "BIER'S NAME: MARY WANG OSKAMP 1732 143RD AVE DATE ISSUED:07/02/2010 V vVNER'S PHONE: 6502910218 SAN LEANDRO,CA 94578 PHONE NO:(510)388-5099 ❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG r ELECT r PLUMB � License Class 9 Lic.# D Cg / MECH r— RESIDENTIAL� COMMERCIAL � Contra Date t Z` (c� I hereby affirm that I a lic sed under the provisions of Chapter 9 JOB DESCRIPTION: INSTALL NEW TEMP POWER POLE (commencing with Section 7000)of Division 3 of the Business&Professions Code and that my license is in full force and effect. I hereby affirm under penalty of perjury one of the following two declarations: I have and will maintain a certificate of consent to self-insure for Worker's Compensation,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$1000 I have and will maintain Worker's Compensation Insurance,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. APN Number:37517027.00 Occupancy Type: APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is correct.I agree to comply with all city and county ordinances and state laws relating PERMIT EXPIRES IF WORK IS NOT STARTED to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save WITHIN 180 DAYS OF PERMIT ISSUANCE OR indemnify and keep harmless the City of Cupertino against liabilities,judgments, 180 DAYS FROM LAST CALLED INSPECTION. costs,and expenses which may accrue against said City in consequence of the granting of this permit. Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section Issued b} Dater Z (d 9.18. Date��c� RE-ROOFS: ❑ OWNER-BUILDER DECLARATION All roofs shall be inspected prior to any roofing material being installed.If a roof is installed without first obtaining an inspection,I agree to remove all new materials for I hereby affirm that I am exempt from the Contractor's License Law for one of inspection. the following two reasons: I,as owner of the property,or my employees with wages as their sole compensation, Signature of Applicant: Date: will do the work,and the structure is not intended or offered for sale(Sec.7044, Business&Professions Code) I,as owner of the property,am exclusively contracting with licensed contractors to ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER construct the project(Sec.7044,Business&Professions Code). I hereby affirm under penalty of perjury one of the following three HAZARDOUS MATERIALS DISCLOSURE declarations: I have read the hazardous materials requirements under Chapter 6.95 of the I have and will maintain a Certificate of Consent to self-insure for Worker's California Health&Safety Code,Sections 25505,25533,and 25534. 1 will maintain Compensation,as provided for by Section 3700 of the Labor Code,for the compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& performance of the work for which this permit is issued. Safety Code,Section 25532(a)should I store or handle hazardous material. I have and will maintain Worker's Compensation Insurance,as provided for by Additionally,should I use equipment or devices which emit hazardous air Section 3700 of the Labor Code,for the performance of the work for which this contaminants as defined by the Bay Area Air Quality Management District I will permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the I certify that in the performance of the work for which this permit is issued,I shall Health&Safety Code,Sections 25505,25533,and 25534. not employ any person in any manner so as to become subject to the Worker's Ovw r o1r,at th rized agent: Compensation laws of California. If,after making this certificate of exemption_ Date: -2, ('D become subject to the Worker's Compensation provisions of the Labor Code,I must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of work's APPLICANT CERTIFICATION for which this permit is issued(Sec.3097,Civ C.) I certify that I have read this application and state that the above information is Lender's Name correct.I agree to comply with all city and county ordinances and state laws relating to building construction,and hereby authorize representatives of this city to enter Lender's Address the above mentioned property for inspection purposes.(We)agree to save mify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the ARCHITECT'S DECLARATION granting of this permit.Additionally,the applicant understands and will comply I understand my plans shall be used as public records. with all non-point source regulations per the Cupertino Municipal Code,Section 9.18• Licensed Professional Signature Date CITY OF CUPERTINO FEE ESTIMATOR-- BUILDING DIVISION ADDRESS: DATE: REVIEWED BY: APN: BP#: "`VALUATION: Iso 'PERMIT TYPE: Electrical Permit PLAN CHECK TYPE: Alteration /Addition/ Repair PRIMARY SFD or Duplex 1,01";`� APPLICATION USE: /-/Cit/1, ,1 r.:�(: TYPE: as 3U APPLIANCE/EQUIP TYPE CAPACITY FEE ID QTY BP FEES Temporary Power 1 ER r<200 1 $42 TOTALS: $42.00 . _ Elec.PlanCheA0.0 hrs $0.00 Elec.Permit Fee: IEPERMIT r ij: Other Elec.Insp. 0.0 hrs $42.00 NOTE: Thesefees are based on the preliminary information u vailable and are only an estimate. Contact the De t or addn'l info. FEE ITEMS (Fee Resolution 09-05I Etf.' 7/0.9) FEE QTY/FEE MISC ITEMS PME Plan Check: $C.00 PME Unit Fee: $42.00 PME Permit Fee: $42.00 Travel Documentation Fee: ITRA VDOC $42.00 )", Select an Administrative Item I31d.- Stds Commission Fee: $C.00 SUBTOTALS: $126.00 $0.00 TOTAL FEE-T $126.00 Revised: 6/30/2010 CITY OF CUPERTINO 4 ITEMS OF 8 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 37'517027. 00 DATE ISSUED. . . . . . . : 07,/02/2010 RECEIPT #. . . . . . . . . : BS000010778 REFERENCE ID # . . . : 10070035 SITE ADDRESS . . . . . : 10:385 CALVERT DR SUBDIVISION . . . . . . CITY . . . . . . . . . . . . . . CUERTINO IMPACT AREA . . . . . . OWNER . . . . . . . . . . . . : MA-2Y WANG OSKAMP ADDRESS . . . . . . . . . . : 10385 CALVERT DR CITY/STATE/ZIP . . . : CUERTINO, CA 95014 RECEIVED FROM . . . . : BESTBUILD CONSTRUCT CONTRACTOR . . . . . . . : ZHO�NG MING MA LIC # 31451 COMPANY . . . . . . . . . . : BE;3TBUILD CONSTRUCTION INC ADDRESS . . . . . . . . . . : 1732 143RD AVE CITY/STATE/ZIP . . . : SAN LEANDRO, CA 94578 TELEPHONE . . . . . . . . : (5L0) 388-5099 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- - --------- ---------- ---------- ---------- 1BCBSC VALUATION 1, 000 . 00 1 . 00 0 .00 1. 00 0 . 00 1EPERMITFE FLAT RATE 1. 00 42 . 00 0 .00 42 . 00 0 . 00 1ERT<200 UNITS 1 . 00 42 . 00 0 .00 42 . 00 0 . 00 1TRAVDOC FLAT RATE 1. 00 42 . 00 0 .00 42 . 00 0 . 00 - --------- ---------- ---------- ---------- TOTAL PERMIT 127. 00 0. 00 127 . 00 0 .00 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 402 TEMPORARY POWER CITY OF CUPERTINO TEMP POWER aITYOF CUPERTINO PERMIT APPLICATION FORM APN # „ Date: 7t_ � 7 -7 Building Address: ( o 3 La j verf C7 e r, T I.-V , C l �-o ( ! Owner's Name: Phone #: l Contractor: -T Phone #: �°- J _ 3 _ C v e Q S f80-4( cc fr"C"t i d c, G Fax #: 00 — � Contact: Phone #: M /o " I t/ o - Contractor License #: Cupertino Business License #: Job Description: Residential F1 Commercial ❑ Valuation (cost of project): Type of Construction: N/A $ Z 0 L2.1 Quantity Fee ID Fee Description Fee Group Permit Type IERT>1K Res. Temp PoNver>1K E 1REAP14 Amps 1 ERT<200 Res. Temp PoNver<200 E Amps 1 ERT2001 K Res. Temp PoNver 200-1 K E Amps 1 EPERMITFE Electric Permit Issuance E 1 ELCPLNCK Electric Plan Check E 1BCBSC Cal Bldg Standards B ALL PERMIT _ Commission F 1-e TYPES 1BSEISMICR Seismic Residcntial B 1TRAVDOC Travel & DocLmentation B Fee Revised 0l/07/09 Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 CUPERTINO Fax: 408-777-3333 CONTRACTOR/ SUBCONTRACTOR LIST JOB ADDRESS: r PERMIT# ro' OWNER'S NAME: PHONE # GENERAL CONTRACTO : ( r ' _ BUSINESS LICENSE # o_ ADDRESS: CITY/ZIPCODE: *Our municipal code requires all businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. / I am not using any subcontractors: SiI; ture Date Please check applicable subcontractors and complete the following information: &/ SUBCONTRACTOR BUSINE 3S NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation Fencing Flooring/Carpeting Linoleum/Wood Glass /Glazing Heating Insulation Landscaping Lathing Masonry Painting/Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner/Contractor Signature Date